Meta-analysis of randomized control trials addressing brief interventions in heavy alcohol drinkers.

OBJECTIVE: To assess the effectiveness of brief interventions in heavy drinkers by analyzing the outcome data and methodologic quality. DESIGN: (1) Qualitative analysis of randomized control trials (RCTs) using criteria from Chalmers' scoring system; (2) calculating and combining odds ratios (ORs) of RCTs using the One-Step (Peto) and the Mantel-Haenszel methods. STUDY SELECTION AND ANALYSIS: A MEDLINE and PsycLIT search identified RCTs testing brief interventions in heavy alcohol drinkers. Brief interventions were less than 1 hour and incorporated simple motivational counseling techniques much like outpatient smoking cessation programs. By a single-reviewer, nonblinded format, eligible studies were selected for adult subjects, sample sizes greater than 30, a randomized control design, and incorporation of brief alcohol interventions. Methodologic quality was assessed using an established scoring system developed by Chalmers and colleagues. Outcome data were combined by the One-Step (Peto) method; confidence limits and chi 2 test for heterogeneity were calculated. RESULTS: Twelve RCTs met all inclusion criteria, with an average quality score of 0.49 + or - 0.17. This was comparable to published average scores in other areas of research (0.42 + or - 0.16). Outcome data from RCTs were pooled, and a combined OR was close to 2 (1.91; 95% confidence interval 1.61-2.27) in favor of brief alcohol interventions over no intervention. This was consistent across gender, intensity of intervention, type of clinical setting, and higher-quality clinical trials. CONCLUSIONS: Heavy drinkers who received a brief intervention were twice as likely to moderate their drinking 6 to 12 months after an intervention when compared with heavy drinkers who received no intervention. Brief intervention is a low-cost, effective preventive measure for heavy drinkers in outpatient settings.

Comparison of different methods for the purification of eosinophils from human peripheral blood.

Eosinophils are often purified in discontinuous gradients. Since continuous gradients usually provide a greater recovery of more highly purified cells, the present investigation was undertaken to compare the purification of eosinophils from normal whole blood in continuous and discontinuous gradients of Percoll. Contrary to our expectations, recovery and purity of eosinophils obtained from the discontinuous gradients were comparable to or higher than those from the continuous gradients of Percoll that were tested with whole blood. The purity of the modal fractions of eosinophils from the discontinuous gradients was between 88 and greater than 99% of the nucleated cells and from the continuous gradients, 80 to 93% of the nucleated cells. We have compared continuous and discontinuous gradients with many different kinds of cells. This is the first time we have found continuous and discontinuous gradients equally effective. We speculate this finding is related to the fact that the band capacities are vastly overloaded in these gradients. In addition, we tested the rate of superoxide production by eosinophils from the same donors after their purification by two different methods in discontinuous gradients. Eosinophils purified from normal whole blood in gradients of Percoll by a modification of the method of Roberts and Gallin [1985) Blood 65, 433-440) had a higher rate of superoxide production after stimulation with phorbol myristate acetate than those purified from leukocyte-rich plasma in gradients of Metrizamide by the method of Vadas et al. [1979) J. Immunol. 122, 1228-1236).